Texas sues Biden administration over confidential contraception for teens

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Texas Attorney General Ken Paxton on Thursday announced he is suing the Biden administration over a federal contraception program that provides teens birth control without requiring parental consent. The Title X program has long been the only way minors in Texas can access confidential contraception, but since a court ruling in 2022, Texas providers have been required to get parental sign-off.

Here’s what you need to know

The background: Title X is a Nixon-era program that provides confidential contraception to anyone, regardless of income, immigration status or age. Federal regulations, and several court rulings, have long held that Title X providers cannot require teens to get parental permission to be prescribed birth control.

In 2020, an Amarillo father sued over that provision, saying it violated his parental rights as guaranteed by the Texas Constitution. Alexander Deanda was represented by Jonathan Mitchell, the former Texas Solicitor General and conservative legal firebrand. Mitchell filed the lawsuit in federal court in Amarillo, where only one conservative judge, Matthew Kacsmaryk, hears almost all cases.

Kacsmaryk sided with Deanda, and his ruling effectively required Title X providers in Texas to begin asking for parental consent to prescribe birth control. The 5th U.S. Circuit Court of Appeals upheld that decision in March.

In 2021, while this case was unfolding, the Biden administration issued a new rule emphasizing that Title X providers “may not require consent of parents or guardians for the provision of services to minors, nor can any Title X project staff notify a parent or guardian before or after a minor has requested and/or received Title X family planning services.”

Why Texas sued: Paxton is arguing that this rule “defies” the 5th Circuit’s judgment, and is asking the courts to issue a permanent injunction against it.

“By attempting to force Texas healthcare providers to offer contraceptives to children without parental consent, the Biden Administration continues to prove they will do anything to implement their extremist agenda — even undermine the Constitution and violate the law,” Paxton said in a statement.

Paxton has filed the lawsuit in federal court in Amarillo, where it will inevitably be heard by Kacsmaryk, who previously ruled against the program’s confidentiality clause.

What Title X providers say: Every Body Texas, the statewide administrator of the Title X program, did not immediately respond to a request for comment. But Title X providers have been outspoken about the importance of confidentiality for their work with minors, some of whom are unable to safely ask their parents for permission to get on birth control.

Project Vida, a Title X provider in El Paso, saw a 50% drop in teens making appointments for contraception after they began requiring parental consent, chief medical officer Dr. Luis Garza told The Texas Tribune in April.

“They’re scared to even come in because they think their parents are going to find out, and they’re missing out on a lot because of that,” Garza said.

Broader impact: Since Title X providers in Texas are already requiring parental consent, this lawsuit won’t change access to contraception for teens here. But it’s part of a broader pattern of limiting access to reproductive health care in the state.

Texas’ teen pregnancy rate ticked up for the first time in decades after the state banned nearly all abortions after about six weeks of pregnancy, according to 2022 fertility data. Now, with abortions virtually banned and contraception further limited, many health care providers and advocates are worried about a further spike in those numbers.

Teens who can’t get parental permission to get on birth control are “the ones that tend to be invisible to the health care system, until they show up pregnant or with an STD,” Dr. Josephine Porter, chief medical officer at Tyler Family Circle of Care, told the Texas Tribune in April.

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